Do the Waive

Graduates in the MD Class of 2020 will be the first in the nation to leave medical school with training that allows them to prescribe medications to treat opioid use disorder in any US state.

The Drug Abuse Treatment Act of 2000 (DATA 2000) requires physicians to obtain a waiver to prescribe FDA-approved medications including buprenorphine and naloxone, commonly used in medication-assisted treatment (MAT). With the training they receive at The Warren Alpert Medical School, students will be able to apply for the waiver once they graduate, earn a full medical license, and complete US Drug Enforcement Administration registration.

While the curriculum has been in place since 2017, the ability to obtain a waiver had applied only to graduates practicing in Rhode Island. After being certified by the Substance Abuse and Mental Health Services Administration (SAMHSA) in late 2019, the training now applies to those practicing anywhere in the country.

“We’re the first school to do this,” says Sarita Warrier, MD, assistant dean of medical education. “We feel like we’re really pushing the opioid use disorder curriculum forward—not just here at Brown, but it’s moving the national view of such curriculums as well.”

Thanks to federal legislation passed in 2018—the SUPPORT for Patients and Communities Act, based in part on research from the Medical School—any medical school curriculum certified by SAMHSA can count for DATA 2000 waiver training. SAMHSA’s backing is what helped turn the school’s extensive opioid use disorder curriculum into the first waiver program of its kind in the US, Warrier says.

“This is definitely a stamp of approval,” she says. “SAMHSA is all about helping physicians provide better care to patients, and this certification is their way of saying we’re doing just that.”

Last year, every graduate qualified to receive the waiver to prescribe MAT in Rhode Island. For the MD Class of 2020, every graduate will complete the same requirements, and roughly 40 will complete the training necessary to prescribe nationwide, which was made optional this year. By 2021, every graduate will be qualified to prescribe MAT in all 50 states.

While not every graduate will find themselves needing to prescribe medications like Suboxone, many will—especially in fields like family medicine, internal medicine, psychiatry, and emergency medicine.

“It’s so important that we increase the pool of physicians who will be able to reach out to their patients,” Warrier says. “It’s such a crucial way of increasing access.”

“We’re hopefully making an impact on the number of deaths from overdose,” adds Paul George ’01 MD’05 RES’08, associate dean of medical education. “We may not see it for a few years until our graduates start going out into the world and treating their own patients, but that’s ultimately the result we’d like to see.”